| NPI | 1134281603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 068-000609) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 0000211) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2010-12-08 |